Is echo guide foam sclerotherapy safe in treating perforator vein problem with history of PE?

Massive PE in 2014. Likely caused by birthcontrol. Discontinued them.No longer on any blood thinners. Pain in left leg on shin since dec.2015. Had VNUS of left upper leg in february. Didnt help. Had sclerotherapy in april. Didnt help. 2nd opinion in vein clinic. They say 3 varicose veins caused by defect perforator vein. They want to give my echo guided Foam sclero with 7 days of fragmin (blood thinner) injections. Is this safe in my case? Can the foam leak into deep system from perforator vein?

Doctor Answers 2

Perforator vein treatment under ultrasound guidance

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Certainly, ultrasound guidance is preferred versus no visualization when treating perforator veins. 

H Karamanoukian MD FACS

certified vein specialist from ABVLM

Perforating veins

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Your question is complicated and difficult to answer without more info but first of all, I would want to be sure that the varicose veins are the cause of the pain. Perforating veins rarely cause pain.  Secondly, injecting foam will enter the deep system but is usually flushed out immediately so there is a minimum risk of developing DVT after foam injection but there is some risk.

John Landi, MD
Naples General Surgeon

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